Does Intramedullary Signal Intensity on MRI Affect the Surgical Outcomes of Patients with Ossification of Posterior Longitudinal Ligament?

Choi, Jae Hyuk; Shin, Jun Jae; Kim, Tae Hong; Shin, Hyung Shik; Hwang, Yong Soon; Park, Sang Keun

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자료유형: 학술저널

저자정보: Choi, Jae Hyuk (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) Shin, Jun Jae (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) Kim, Tae Hong (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) Shin, Hyung Shik (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) Hwang, Yong Soon (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine) Park, Sang Keun (Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine)

저널정보: 대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제56권 제2호

발행연도: 2014.1

수록면: 121 - 129 (9page)

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Objectives : Patients with cervical ossification of posterior longitudinal ligament (OPLL) are susceptible to cord injury, which often develops into myelopathic symptoms. However, little is known regarding the prognostic factors that are involved in minor trauma. We evaluated the relationship between minor trauma and neurological outcome of OPLL and investigated the prognostic factors with a focus on compressive factors and intramedullary signal intensity (SI). Methods : A total of 74 patients with cervical myelopathy caused by OPLL at more than three-levels were treated with posterior decompression surgeries. We surveyed the space available for spinal cord (SAC), the severity of SI change on T2-weighted image, and diabetes mellitus (DM). The neurological outcome using Japanese Orthopedic Association (JOA) scale was assessed at admission and at 12-month follow-up. Results : Among the variables tested, preoperative JOA score, severity of intramedullary SI, SAC, and DM were significantly related to neurological outcome. The mean preoperative JOA were $11.3{\pm}1.9$ for the 41 patients who did not have histories of trauma and $8.0{\pm}3.1$ for the 33 patients who had suffered minor traumas (p<0.05). However, there were no significant differences in the recovery ratios between those two groups. Conclusions : Initial neurological status and high intramedullary SI in the preoperative phase were related to poorer postoperative outcomes. Moreover, the patients with no histories of DM and larger SACs exhibited better improvement than did the patients with DM and smaller SACs. Although the initial JOA scores were worse for the minor trauma patients than did those who had no trauma prior to surgery, minor trauma exerted no direct effects on the surgical outcomes.

#Ossification of the posterior longitudinal ligament #Spinal cord injury #Surgical treatment #Magnetic resonance imaging

참고문헌 (36)

참고문헌 신청

Baba H / 1995 / Flexibility and alignment of the cervical spine after laminoplasty for spondylotic myelopathy. A radiographic study / Int Orthop 19:116~121

Bracken MB / 1990 / A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal-cord injury. Results of the Second National Acute Spinal Cord Injury Study / N Engl J Med 322:1405~1411

Carette S / 2005 / Clinical practice. Cervical radiculopathy / N Engl J Med 353:392~399

정천기 / 2008 / Post-Laminectomy Kyphosis in Patientswith Cervical Ossification of the PosteriorLongitudinal Ligament :Does It Cause Neurological Deterioration? / 대한신경외과학회지 43(6):259~264

Cho YE / 2011 / The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy / Eur Spine J 20:2267~2274